[The automated determination of the dibucaine number using the Greiner G450 selective analyzer. A routine parameter of significance?].
Patients who are homozygous for an atypical pseudocholinesterase enzyme (PCHE) suffer a prolonged neuromuscular block after succinylcholine application. In order to determine which patients have atypical PCHE preoperatively, an automated method using the Greiner G450 analyzer was developed.


METHODS
The contribution of blocked and unblocked PCHE by dibucaine hydrochloride (optimal concentration 10(-4) mol/l;) was determined in 113 patients (ASA groups 1-2) and the dibucaine number (DN) was evaluated.


RESULTS
According to the DN, the patients were subdivided into three groups: group A (PCHE 5.01 +/- 1.64 kU/l, DN 74.47 +/- 0.87); group B (PCHE 4.28 +/- 3.41 kU/l, DN 64.95 +/- 3.41); group C (PCHE 1.33 +/- 0.54 kU/l, DN 13.08 +/- 2.19;). PCHE and DN of group A corresponded with normal standard values, whereas the patients in groups B and C could be considered to be patients with heterozygous and homozygous atypical PCHE, respectively.


CONCLUSIONS
Our data indicate that an automated analysis of blocked and unblocked PCHE with the Greiner G450 can be easily done in a routine laboratory. By interpreting the DN, the possible risks of delayed succinylcholine degradation can probably be prevented.
Gottardis
M
M
Universitätsklinik für Anaesthesie und Allgemeine Intensivmedizin, Innsbruck.
Schmoigl
C
C
Mitterschiffthaler
G
G
Mutz
N
N
Benzer
A
A
Schobersberger
W
W
Reitter
B
B
Jarosch
E
E
D002091:Butyrylcholinesterase / Q000097:blood / Q000235:genetics*; D003992:Dibucaine; D005260:Female; D006720:Homozygote; D006801:Humans; D008297:Male; D009469:Neuromuscular Junction / Q000187:drug effects; D011300:Preoperative Care; D013390:Succinylcholine / Q000494:pharmacology; D013997:Time Factors
D002091:Butyrylcholinesterase; D013390:Succinylcholine; D003992:Dibucaine
Die automatisierte Bestimmung der Dibucainzahl am selektiven Analyzer GREINER G450. Ein Routineparameter von Bedeutung?